The present invention relates to an apparatus that combines the advantages of electrosurgery and laser beam delivery techniques in a single device for use in surgery. The combined delivery device may be a handpiece at the end of a laser waveguide or an endoscopic delivery device. The electrosurgery R.F. generator for use with the device can be a stand-alone unit or built into the laser generating system, for example, a CO.sub.2 laser system.
Electrosurgery has for decades been used to cut and coagulate tissue. Such systems are found in most operating rooms today. Electrosurgery units use radio frequency (R.F.) energy to create an A.C. arc which is applied to the tissue where the energy burns and coagulates the tissue. This results in reduced blood loss and is important in most surgical procedures. Currently, electrosurgery devices are separate instruments from other surgical devices, for example, laser beam delivery systems which may be used to cut tissue, for example, CO.sub.2 laser systems. Although electrosurgical devices can cut tissue to some extent, they are very crude and destructive to the tissue.
CO.sub.2 lasers, in contrast, provide a means for accurate cutting of tissue, but do not provide substantial coagulation effects.
During laser procedures with CO.sub.2 lasers there are often problems with opened blood vessels that cannot be cauterized with a fan beam of the laser energy. This occurs with vessels larger than 0.5 mm.
Furthermore, there is some difficulty and time elapsed between the start of bleeding during surgery and the application of electrosurgery to stop the blood flow. The use of separate instruments for laser surgery and electrosurgery techniques therefore is not only inconvenient, but unacceptable during surgical techniques where speed is necessary. Furthermore, due to excessive bleeding, suction and clean-up must occur before the CO.sub.2 laser can be used again.
Typical electrosurgery units comprise a radio frequency (R.F.) generator, an electrode (handpiece or pencil) and a cathode (a grounding pad). In the early 1970s, development of solid state electronic R.F. generators provided surgeons a safe power supply which did not pose the risk of burns that existing spark gap generators did. As a result of this development and recognition of the patient benefits of (1) shorter operating time and (2) reduced blood loss, surgeons rapidly adapted aggressive electrosurgery techniques. Today these techniques are used in nearly every hospital operating room procedure.
Electrosurgery cuts and coagulates with rather gross damage to tissue. In the late 1970s and early 1980s, the CO.sub.2 laser began to be used in surgery because it could cut, coagulate or ablate tissue. It is an excellent cutting device but a poor coagulating device. In the 1980s, the YAG laser started to be used as a coagulating device which, however, does not cut well.
Applicant is aware of the following patents relating to electrosurgery and microwave instruments and techniques: